Rehabilitation of three elements with three CSR implants of different neck morphology - a clinical case

Figure 1: Occlusal view of the elements 1.4, 1.5, 1.6

Figure 2: Endoral rx in which the forcation of element 16 is highlighted

Figure 3: Conservative extraction of the natural alveolus, in which the crown is divided into three parts in order to maintain the residual bone anatomy and the interradicular septum

Figure 4: element 1.6 after extraction

Figure 5: The interradicular septum is prepared with burs to make a sinus lift

Figure 6: The collagen and then the graft material are inserted inside the septum

Figure 7: A CSR ø 3.80 mm Wide Neck implant is inserted into the alveolus

Figure 8: Occlusal view after implant placement (afterwards the site was covered with a periodontal wrap for a week)

Figure 9: Endoral rx after implant placement

Figure 10: The site is left to heal by second intention. This photo shows the healing of the site after 2 weeks of surgery

Figure 11: This photo shows the healing of the site after 4 weeks of surgery

Figure 12: This photo shows the healing of the site after 8 weeks of surgery. It is possible to appreciate the soft tissue volume gain

Figure 13: Four months after surgery, the site has completely healed and the impression is taken

Figure 14: After taking the impression and developing the model, the prosthesis is designed with Exocad software

Figure 15: The crown made with CAD/CAM system is tested on a model

Figure 16: Screwed prosthesis made with CAD / CAM system at the time of delivery

Figure 17: Endoral Rx at the time of crown delivery

Figure 18: It is possible to notice the growth of the papillae around the crown after two months

Figure 19: Endoral Rx after two months

Figure 20: As shown in the Rx, in the second surgical phase both the extraction of the element 14 (a CSR ø 3.80 mm Straight Neck implant is inserted) and the extraction of the element 15 (a mini sinus rise is carried out and a CSR system ø 4.20 Reduced Neck)

Figure 21: Temporary and polished PEEK temporary posts are screwed to the implants

Figure 22: Vestibular image of screw-retained temporary crowns, delivered the same day of surgery

Figure 23: At 5 months from the surgery the impression is taken with Pick-up transfer

Figure 24: Delivery of the final crowns after 1 month. it is possible to notice the excellent state of health of the soft tissues

Figure 25: Rx of control: on the element 16 it is possible to note the completion of the implant integration, while on the elements 14 and 15 the good bone growth around the three different neck morphologies is visible